Provider Demographics
NPI:1992916100
Name:ALVARADO, AWILDA (PHD)
Entity type:Individual
Prefix:
First Name:AWILDA
Middle Name:
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND THOMASVILLE PARK
Mailing Address - Street 2:EDIF. 1 APT. 1104
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-8801
Mailing Address - Country:US
Mailing Address - Phone:787-602-1280
Mailing Address - Fax:787-277-9595
Practice Address - Street 1:COND THOMASVILLE PARK
Practice Address - Street 2:EDIF. 1 APT. 1104
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-8801
Practice Address - Country:US
Practice Address - Phone:787-602-1280
Practice Address - Fax:787-277-9595
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1884103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical